gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

The importance of MRI quality and viewer experience to detect an adenoma in Cushing’s disease

Die Bedeutung der MRT-Qualität und der Erfahrung des Betrachters für die Erkennung eines Adenoms bei Morbus Cushing

Meeting Abstract

  • presenting/speaker Isabella Nasi-Kordhishti - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland
  • Sabrina Giese - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland
  • Benjamin Bender - Universitätsklinikum Tübingen, Klinik für Diagnostische und Interventionelle Neuroradiologie, Tübingen, Deutschland
  • Jürgen B. Honegger - Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocP167

doi: 10.3205/22dgnc479, urn:nbn:de:0183-22dgnc4799

Veröffentlicht: 25. Mai 2022

© 2022 Nasi-Kordhishti et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Cushing's disease (CD) is a serious illness, in which not only the endocrinological diagnostics, but also the detection of an adenoma by imaging is a challenge. Various magnetic resonance imaging (MRI) protocols and their sensitivity have been described. The aim of this study is to assess the difference in adenoma depiction between external MRI and sensitive MRI of the pituitary acquired in a highly experienced pituitary center. The MRI interpretation by external radiologists, internal neuroradiologist and pituitary surgeon are compared.

Methods: We retrospectively analyzed 139 patients with CD, who underwent first time transsphenoidal surgery in our department and had a preoperative external and internal MRI. Preoperative interpretation of MRI was performed independently by different viewers (external radiologist, internal neuroradiologist and pituitary surgeon). Intraoperative detection of an adenoma and endocrinological remission provided proof of the true adenoma location

Results: On the external MRI, the external radiologist described 78 adenomas and the pituitary surgeon 94 adenomas. On the internal MRI, the neuroradiologist described 118 adenomas and the pituitary surgeon 127 adenomas. Based on external MRI, the true localization of the adenoma was correctly predicted in only 46.7% of the patients by the external radiologist, and in 65.7% by the pituitary surgeon. , Based on internal MRI, the true location of the adenoma was correctly predicted in 80.0% by the internal neuroradiologist, and in 94.3% by the pituitary surgeon.

Conclusion: Both quality of MRI and viewer’s experience are decisive for detection of microadenomas in CD. Preoperative visualization of a pituitary adenoma by MRI is an important predictor for surgical success in CD. Patients with CD should present to centers with high experience in pituitary diseases.